Excelling in the Clinic: A Concise Guide for Medical Students

Preface
Contents
1: The Importance of Primary Care
	1.1	 The Power of Incremental Care
	1.2	 Effects of High-Quality Primary Care on Health Outcomes
	1.3	 The Long-Term Physician-Patient Relationship
	1.4	 Seeing the Big Picture
	References
2: Medical Education in the Outpatient Clinic: Benefits and Barriers
	2.1	 Benefits: Role Modeling, Mentoring, and One-on-One Teaching
	2.2	 Barriers: Stressed Clinical Preceptors and Student Preconceptions
	References
3: Clinic Settings, Schedules, and Structures
	3.1	 Settings
	3.2	 Schedules
	3.3	 Structures
	3.4	 Other Clinic Experiences
	References
4: COVID-19 and the Rapid Rise of Telemedicine
	4.1	 How COVID-19 Has Changed Primary Care
	4.2	 Telephone and Video Visits: Benefits and Limitations
	4.3	 Student Participation in Telemedicine
	4.4	 Telemedicine Is Here to Stay
	References
5: Role of the Student in the Outpatient Clinic
	5.1	 Active Versus Passive Clinic Experiences
	5.2	 What Your Clinic Attending Is Looking For
	5.3	 Increasing the Level of Responsibility: The RIME Framework
	5.4	 Working with the Clinic Staff
	5.5	 Following Up on Test Results and Consults
	References
6: Preparing to See the Patient
	6.1	 Chart Review and Creating an Agenda for the Visit
	6.2	 More Thoughts on the Agenda: “I Just Want to Know If I’m Healthy Enough for Bacon”
	References
7: The Patient-Centered Interview
	7.1	 Basics of the Patient-Centered Interview
	7.2	 Greeting and Introduction
	7.3	 Begin with an Open-Ended Question, and Listen Carefully to the Answer
	7.4	 Look at the Patient, Not the Screen
	7.5	 Med Reconciliation
	7.6	 Evaluate New Symptoms with Pertinent Positives and Negatives
	7.7	 Review of Systems
	7.8	 Using Motivational Interviewing for Behavioral Change
	7.9	 Dealing with Talkative, Angry, and Distracted Patients
	7.10	 Cyberchondriasis
	7.11	 Shared Decision-Making
	References
8: The Physical Exam
	8.1	 (Lack of) Evidence for the Routine Physical Exam
	8.2	 The Irrational Physical Exam?
	8.3	 Checking Your Exam Findings with the Attending
	8.4	 Point-of-Care Ultrasonography in the Primary Care Clinic
	References
9: The Concise Oral Case Presentation
	9.1	 The SOAP-Style Oral Presentation
	9.2	 Schema for the Oral Case Presentation in the Clinic
	9.3	 Using the Problem List as a Guide
	9.4	 Examples of Oral Presentations
		9.4.1	 The Routine Follow-Up Visit
		9.4.2	 The Posthospital Visit
		9.4.3	 The Urgent Visit
		9.4.4	 The New Patient Visit
	References
10: Discussing the Case
	10.1	 Identifying Key Learning Points from the Case
	10.2	 Using SNAPPS for Case Presentation, Discussion, and Teaching
		10.2.1	 Standard Case Discussion
		10.2.2	 SNAPPS-Style Case Discussion (Same Patient)
	10.3	 Researching the Case and Reporting Your Findings
	10.4	 Questioning Dogma in the Clinic
	10.5	 Responding to Feedback
	References
11: Writing a Clinic Note
	11.1	 The Classic SOAP Note and Its Function
	11.2	 How Not to Write a Progress Note: Things to Avoid
	11.3	 Examples of Concise Clinic Notes
		11.3.1	 Note #1. 55-Year-Old Woman
		11.3.2	 Note #2. 71-Year-Old Man
		11.3.3	 Note #3. 71-Year-Old Woman
		11.3.4	 Note #4. 67-Year-Old Man
		11.3.5	 Note #5. 74-Year-Old Man
		11.3.6	 Note #6. 55-Year-Old Man
		11.3.7	 Note #7. 66-Year-Old Man
		11.3.8	 Note #8. 92-Year-Old Man
12: Service-Learning Clinics
	12.1	 Working in Shelters and Homeless Clinics
	12.2	 Student-Run Free Clinics
	12.3	 Challenges and Satisfactions of Caring for the Underserved
	12.4	 The Silver Chalice
	References
13: Careers in Primary Care
	13.1	 Traditional, Nontraditional, and Academic Practice Options
	13.2	 Finding Your Niche in Primary Care
	13.3	 Academic Careers in Primary Care: How to Get There
	13.4	 The Future of Primary Care
	References
Subject Index
Author Index